Individual provider Active NPI

Cynthia Delaney Clark, LMFT

  • Marriage & Family Therapist
  • Williamsburg, VA
National Provider Identifier
1225265317
Registry record updated Jun 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
0717000093 Issued in VA
Practice address
1769 Jamestown Rd
Suite 114
Williamsburg, VA 23185
Phone
(757) 220-8550
NPI assigned
Jun 16, 2009
Last updated
Jun 16, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 0717000093 VA Primary
Marriage & Family Therapist 106H00000X MT1331 FL

Addresses

Primary practice location

1769 Jamestown Rd
Suite 114
Williamsburg, VA 23185

Mailing address

1769 Jamestown Rd
Suite 114
Williamsburg, VA 23185
Phone (757) 220-8550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MT1331FLMDMarriage & Family Therapist
0717000093VAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245110400000",
    "number": "1225265317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1769 JAMESTOWN RD",
            "address_2": "SUITE 114",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "23185",
            "telephone_number": "757-220-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1769 JAMESTOWN RD",
            "address_2": "SUITE 114",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "23185",
            "telephone_number": "757-220-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CYNTHIA",
        "middle_name": "DELANEY",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-16",
        "last_updated": "2009-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717000093",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT1331",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.